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General NPI Number Information
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NPI Number | 1215734181
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Entity Type | Organization
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Legal Business Name | RAZA UDDIN OD LLC
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 409 BENEDICTA AVE
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City | TRINIDAD
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State | CO
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Zip | 81082-2004
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Country | US
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Telephone | 719-846-9291
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Fax |
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Provider Business Mailing Address
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Address Line | 8239 S KEARNEY ST
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City | CENTENNIAL
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State | CO
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Zip | 80112-3002
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAZA UDDIN
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Credential |
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Telephone | 303-383-9377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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